Nsogbu njikọ bụ akụkụ nke ọrịa imeju na isi ihe dị mkpa na ọtụtụ akara amụma. Mgbanwe na nguzozi nke hemostasis na-eduga na ọbara ọgbụgba, nsogbu ọbara ọgbụgba abụrụla nnukwu nsogbu ahụike mgbe niile. Ihe ndị na-akpata ọbara ọgbụgba nwere ike kewaa n'ime (1) ọbara mgbali elu portal, nke na-enweghị ihe jikọrọ ya na usoro hemostatic; (2) ọbara ọgbụgba ọnya mucosal ma ọ bụ puncture, nke na-abụkarị na mgbasa nke thrombus ma ọ bụ nnukwu fibrinolysis, nke a na-akpọ accelerated intravascular coagulation na fibrinolysis na ọrịa imeju Melt (AICF). Usoro nke hyperfibrinolysis edoghị anya, mana ọ gụnyere mgbanwe na intravascular coagulation na fibrinolysis. A na-ahụ coagulation na-adịghị mma na portal vein thrombosis (PVT) na mesenteric vein thrombosis, yana deep vein thrombosis (DVT). Ọnọdụ ahụike ndị a na-achọkarị ọgwụgwọ ma ọ bụ mgbochi anticoagulation. Microthrombosis na imeju nke hypercoagulation na-akpata na-akpatakarị atrophy imeju.
A kọwapụtala ụfọdụ mgbanwe dị mkpa na ụzọ hemostasis, ụfọdụ na-agba ọbara, ndị ọzọ na-akpụkọkwa (Foto nke 1). Na cirrhosis imeju kwụsiri ike, a ga-agbanwe usoro ahụ n'ihi ihe ndị na-adịghị edozi ahụ, mana nguzozi a adịghị eguzosi ike ma ihe ndị ọzọ ga-emetụta ya nke ukwuu, dị ka ọnọdụ olu ọbara, ọrịa sistemụ, na ọrụ akụrụ. Thrombocytopenia nwere ike ịbụ mgbanwe ọrịa kachasị na-emekarị n'ihi hypersplenism na mbelata thrombopoietin (TPO). Akọwakwala nsogbu platelet, mana mgbanwe ndị a na-egbochi ọbara na-ebelata nke ukwuu site na mmụba na endothelial-derived von Willebrand factor (vWF). N'otu aka ahụ, mbelata na ihe ndị na-akpata procoagulant sitere na imeju, dị ka ihe V, VII, na X, na-eduga na ogologo oge prothrombin, mana nke a na-ebelata nke ukwuu site na mbelata na ihe ndị na-akpata anticoagulant sitere na imeju (karịsịa protein C). Na mgbakwunye, mmụba nke endothelial-derived factor VIII na obere protein C na-eduga na ọnọdụ hypercoagulant dịtụ. Mgbanwe ndị a, tinyere nsogbu akwara dị n'etiti na mmebi endothelial (triad nke Virchow), dugara na ọganihu synergistic nke PVT na DVT mgbe ụfọdụ n'ime ndị ọrịa nwere cirrhosis imeju. Na nkenke, a na-agbanwegharị ụzọ hemostatic nke cirrhosis imeju n'ụzọ na-adịghị akwụsi ike, a pụkwara ịtụgharị ọganihu nke ọrịa ahụ n'akụkụ ọ bụla.
Ntụaka: O'Leary JG, Greenberg CS, Patton HM, Caldwell SH.AGA Mmelite Ọgwụgwọ Ahụike: Mkpọchi na Ọrịa Cirrhosis.Gastroenterology.2019,157(1):34-43.e1.doi:10.1053/j.gastro.2019.03.070.
Kaadị azụmaahịa
WeChat nke Chaịna